Adolescent eating disorder: bulimia

Bulimia, an eating disorder, recently has emerged as a major mental health problem, especially among adolescent females. The bulimic experiences periods of compulsive binge eating followed by purges to rid the body of unwanted calories. Binges are triggered by intense emotional experiences, such as loneliness, anger, rejection, or stress. Associated features of bulimia are secretiveness, depression, drug abuse, preoccupation with body image and sexual attractiveness, and an awareness that the behavior is abnormal. The physical side effects include dental problems, inflamed esophagus, EEG abnormalities, abdominal or urinary disturbances, and changes in blood sugar level. Cognitive disturbances related to binging and purging are perfectionistic, egocentric, and distorted thinking, misconceptions about nutritional requirements, unreasonable goals and expectations, and disturbed affect. Bulimics resist treatment; however, such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising.     

Variables which differentiate placement of adolescents into juvenile justice or mental health systems

Studies of the variables that determine whether an adolescent is placed in the mental health or juvenile justice system for treatment have led to conflicting conclusions based on impressionistic data. The primary hypothesis of this study--that demographic variables would and personality/psychopathology variables would not differentiate into which system a youth will be placed--was supported. Adolescents were studied at intake into both the juvenile justice system and the mental health system. Data were collected on demographics (structured interviews), personality/psychopathology (MMPI), social adjustment (CAAP), and academic achievement (PIAT). A discriminant function analysis identified eight statistically significant variables which differentiated the two groups. In order of decreasing importance they are: ethnicity, gender, MMPI-depression, previous mental health history, CAAP-productivity, drug use, parental marital history, and parental religious preference.     

Identity conflict in Mexican-American adolescents

Mexican-American adolescents of migrant origin present conflicting attitudes in their selection of ideal characters and images for identification. As minority members, identification with members of outside groups appears blocked for them. At the same time, encounters with outside society seem to undermine identification processes that develop within their own group, their families, and community. This study concludes that relationships of dominance and dependence in the outside society foster inhibitions to the process of identification, and disturbances in the mechanisms of defense in the minority member. These relationships seem to interfere with the internalization and adoption of significant others' characteristics and attitudes.     

The princess in the tower: Zelda Fitzgerald's creative impasse

Gifted women often find it difficult to integrate an acceptable social image with an autonomous artistic identity. This paper explores the ambitions and conflicts of Zelda Fitzgerald, who aspired to be an artist in several fields, but whose fame is largely contingent on the role she played in the life of her husband, F. Scott Fitzgerald. Zelda's flamboyant public pose, which served as a model for many of her husband's literary characters, is interpreted as an attempt to organize a consistent identity configuration by means of constant appeals for applause from an admiring audience. But although this configuration provided some stability and cohesion for her during her twenties, it was a superficial and vulnerable structure which failed to support her serious artistic aspirations. An examination of the separation conflicts and difficulties in internalization which contributed to Zelda's dilemma leads to a consideration of the role of the father in the organization of differentiated female achievements. Although Zelda Fitzgerald's pathology was extreme, her struggles suggest useful insights into the intrapsychic and social barriers commonly confronting creative women.     

Jamaican Family Structure: The Paradox of Normalcy

The relationship between basic research, theory, and clinical work with families is conceptualized during a discussion of Jamaican family structure and the application of change theory to a clinical case of depression in a Jamaican woman. It was found that three types of family structure are prevalent in Jamaica. The European ideal of a patriarchal-patrifocal structure creates problems for working-class Jamaicans. General system theory provides support for a different model. Change theory is applied to resolve the paradox created by the European model.